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抗 Ro52 和/或抗 Ro60 免疫反应性:自身抗体与疾病的关联。

Anti-Ro52 and/or anti-Ro60 immune reactivity: autoantibody and disease associations.

机构信息

Institute for Autoimmune Systemic and Neurological Diseases, Athens, Greece.

Department of Internal Medicine and Autoimmune Diseases, Euroclinic of Athens, Greece.

出版信息

Clin Exp Rheumatol. 2020 Jul-Aug;38 Suppl 126(4):134-141. Epub 2020 Feb 18.

Abstract

OBJECTIVES

This study aims to characterise the clinical phenotype and autoantibody associations in an autoimmune population positive for anti-Ro52 and/or anti-Ro60 autoantibodies.

METHODS

The sera of 508 individuals tested for autoantibody presence were found positive for anti-Ro52 and/or anti-Ro60. Medical records were available for 272 of them. Correlations of clinical, laboratory and other autoantibodies as well as disease phenotypes with the presence of anti-Ro52 and/or anti-Ro60 reactivity were examined.

RESULTS

Combined serum anti-Ro52/anti-Ro60 reactivity was the most frequent one, mostly seen in Sjögren's syndrome (SS) and systemic lupus erythematosus (SLE) patients. In these patients this reactivity strongly associated with anti-La and/or anti-dsDNA autoantibodies. SS patients with combined anti-Ro52/anti-Ro60 and anti-La reactivity had clinical and/or laboratory risk factors for lymphoma development. Solo anti-Ro52 reactivity was primarily found in idiopathic inflammatory myopathies (IIM), primary biliary cholangitis (PBC), rheumatoid arthritis (RA) and SS patients. Solo anti-Ro52 also associated with anti-Jo1 and anti-M2 autoantibodies and with interstitial lung disease (ILD) in a context of IIM-related lung injury. ILD patients with combined anti-Ro52/anti-Ro-60 reactivity were diagnosed mostly as RA and/or SS. Solo anti-Ro60 reactivity strongly correlated with oral ulcers and co-existed with autoantibodies to Sm and nRNP/Sm.

CONCLUSIONS

Testing for autoantibodies against both Ro peptides may guide diagnosis, classify clinical manifestations in disease entities and define prognosis in certain autoimmune disorders. A distinct weight could be given to the isolated anti-Ro specificities in the SS classification criteria.

摘要

目的

本研究旨在描述抗 Ro52 和/或抗 Ro60 自身抗体阳性的自身免疫人群的临床表型和自身抗体相关性。

方法

对 508 例检测自身抗体阳性的个体血清进行检测,发现其中 272 例血清抗 Ro52 和/或抗 Ro60 阳性。对他们的病历记录进行了评估。检查了临床、实验室和其他自身抗体以及疾病表型与抗 Ro52 和/或抗 Ro60 反应性存在的相关性。

结果

联合血清抗 Ro52/抗 Ro60 反应性最常见,主要见于干燥综合征(SS)和系统性红斑狼疮(SLE)患者。在这些患者中,这种反应与抗 La 和/或抗 dsDNA 自身抗体强烈相关。具有联合抗 Ro52/抗 Ro60 和抗 La 反应性的 SS 患者具有淋巴瘤发展的临床和/或实验室危险因素。单独的抗 Ro52 反应性主要见于特发性炎症性肌病(IIM)、原发性胆汁性胆管炎(PBC)、类风湿关节炎(RA)和 SS 患者。单独的抗 Ro52 也与抗 Jo1 和抗 M2 自身抗体相关,与 IIM 相关肺损伤中的间质性肺病(ILD)相关。具有联合抗 Ro52/抗 Ro-60 反应性的ILD 患者主要被诊断为 RA 和/或 SS。单独的抗 Ro60 反应性与口腔溃疡强烈相关,并存有 Sm 和 nRNP/Sm 自身抗体。

结论

对两种 Ro 肽的自身抗体检测可能有助于诊断、分类疾病实体中的临床表现,并在某些自身免疫性疾病中确定预后。在 SS 分类标准中,孤立的抗 Ro 特异性可能具有独特的权重。

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